Forty and forward?

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The first edition of Australian Prescriber was published in the spring of 1975 by the Australian Department of Health. It aimed to ‘assist clinicians, whatever their field, to prescribe the most appropriate treatment’.1 Forty years on, Australian Prescriber has become a trusted part of Australian practice. A whole generation of health professionals has grown up with access to independent information about therapeutics.

Despite its national and international influence, the existence of Australian Prescriber has sometimes been in doubt. In 1982, budget cuts led to the brief disappearance of Australian Prescriber while plans were made to privatise the journal. One possibility was that Australian Prescriber would be taken over by the Australian Medical Association, the publisher of the Medical Journal of Australia. However, the Editor of that journal correctly pointed out that you could not have Australian Prescriber associated with advertisements from pharmaceutical companies. It has recently emerged that this comment contributed to that Editor’s premature departure from the Medical Journal of Australia.2

At the 30th anniversary of Australian Prescriber in 2005 the problems of the past appeared to have been resolved.3 The National Prescribing Service (now known as NPS MedicineWise) had taken over responsibility for the publication of Australian Prescriber in 2002. Certain safeguards were built into the contract as the Executive Editorial Board had concerns over editorial independence.4 The contract included distributing Australian Prescriber in print and electronic formats, free of charge and free of advertising, six times a year. This routine is now well established.

Over the past 10 years Australian Prescriber has continued to grow. While the print distribution has remained stable, at around 50 000 copies, most of the growth has been in the online readership with approximately 250 000 unique visitors to the Australian Prescriber website each month. A website for mobile devices was established in 2013 and this attracts a further 125 000 unique users each month. Social media was in its infancy in 2005, but since 2012 readers have been able to get updates by following Australian Prescriber on Twitter.

In 2015 the first Australian Prescriber smartphone ‘app’ was launched. This was a new way to deliver information, about anaphylaxis management and the doses of emergency drugs, that had previously been available in print. The Doctor’s Bag app has been well received with over 2500 downloads in the first month.

Work is also underway to meet the new standards of scholarly publication. These standards are partially a response to the recent rise of predatory medical journals.5 While people value open-access journals, authors usually have to pay fees to have their work published in commercial publications. However, this publishing model has resulted in the emergence of new journals which appear willing to publish anything for money. Predatory journals can exploit people who are desperate to publish their work. There are even alleged cases of fake peer-review.6

Although Australian Prescriber has always met the standards for MEDLINE listing, the journal has not been given priority for inclusion in that database. To facilitate increased access, we are currently working to make the journal available through PubMed Central. This should make it easier for readers and researchers to find the articles they want.

Maintaining the quality of Australian Prescriber requires investment. The growth of Australian Prescriber has been achieved despite funding being unchanged for many years. While this has been a challenge over the past decade, the journal is reaching a point where future development may be constrained. In 2005 the Australian Prescriber website was considered advanced, but now needs to be upgraded, not least because of the huge numbers of people visiting the website.

In view of the increasing costs of distributing a paper journal, NPS MedicineWise is investigating a range of publishing solutions to ensure that health professionals continue to receive the high-quality, evidence-based information they need. This may include seeking additional sources of funding and reducing the print distribution of NPS MedicineWise publications.

Evidence from previous Australian Prescriber readership surveys supports the continuation of the print publication. Other publishers have also found that many health professionals prefer a paper journal. Approximately a third of our online readers also like to read Australian Prescriber in print. A common scenario is for health professionals to go to the website when they want information quickly and to read the paper copy when they want more detail about a topic. While there is increasing use of the internet, is it too soon to expect health professionals to read only online information?

In a recent readership survey 85% of the readers of the print journal said Australian Prescriber had influenced their practice. Significant changes to print distribution may therefore have implications for prescribing. It is important that we continue to provide balance to the printed information supplied directly or indirectly by the pharmaceutical industry.

The Editorial Executive Committee is concerned that all those readers who have opted for the paper journal will not make the switch to the electronic journal. Before making any changes it is essential to seek your views on how Australian Prescriber can continue to reach as many health professionals as possible. There will therefore be a survey of a sample of the readers in the coming weeks. Even if you are not part of the readership survey the Editorial Executive Committee will welcome your comments on the future of the journal.

The 21st century has seen a transformation in publishing. Australian Prescriber has introduced many innovations over the years and will continue to look for new ways to deliver independent drug information to busy health professionals. However, as Australian Prescriber moves forward into its fifth decade, it will be important not to forget the lessons of the past.

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